[Congressional Record Volume 157, Number 2 (Thursday, January 6, 2011)]
[House]
[Pages H98-H101]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
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HEALTH CARE AND THE DEFICIT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 5, 2011, the gentleman from Vermont (Mr. Welch) is recognized
for 30 minutes.
Mr. WELCH. Thank you, Mr. Speaker, and welcome. I want to also thank
the gentleman from New Mexico and welcome him back. Your comments about
trying to work together and bipartisanship, that all makes an awful lot
of sense to me and I hope to all of us. But welcome back, sir.
We are going to have an opportunity, Mr. Speaker, to use this Special
Order half-hour to talk about health care and also about the deficit.
We do want to be bipartisan, but we also want to be real. Our job, as
you know, is to legislate, and we will be judged by our actions, by our
deeds, more than by our rhetoric.
Let me just say that the aspirations that have been enunciated by
many of our Republican leaders are ones I quite admire; an open and
transparent Congress, more open rules, fiscal discipline, things that
are absolutely, fundamentally important to this country, and the
question now is whether there is going to be a follow-through on those
stated goals. The best way to start looking at it is what is going on
with the health care bill, and the decision of the leadership is to
repeal health care.
Now, that is a very radical decision, because as much as there are
legitimate issues, many legitimate issues about that health care bill,
a wholesale repeal as a policy is going to do real damage to real
families in this country, in every district in this country, and it is
also going to immediately increase the deficit by $230 billion.
As is known, that is not the opinion of a Democrat or Republican;
that is the conclusion of the impartial arbiter, the Congressional
Budget Office. So if we are dedicated to fiscal discipline, if we have
got to bring down spending, how can we have as our first act as a
Congress passing a bill that the Congressional Budget Office says will
increase the deficit by $230 billion? It doesn't add up, obviously.
I am going to pause here because I have some of my colleagues who are
going to be called to other locations. I want to start, if I could,
with the gentleman from Colorado, Mr. Perlmutter.
Mr. PERLMUTTER. I thank my friend from Vermont.
I want to piggyback on something that you just said. I hope that we
can and we will work with the Republican majority on a lot of issues to
get people back to work in America, to stop outsourcing jobs to other
countries, to stop importing oil at tremendous price to this country so
that money continues to flow away from the U.S. instead of into the
U.S. I want to work with them on those kinds of things.
But what I am concerned about is something you just mentioned. The
ideology and the radical approach that they are taking to repeal
something that was put into place over the last 2 years but has been
needed by this country for decades is something that I will fight.
Ideological, radical extreme positions are not what the American people
want. They want practical, solid solutions where people are treated
fairly and equally.
In the health legislation, the Affordable Health Care Act that we
passed, the guts of that legislation is about treating people equally.
What I mean by that is we stop discriminating against people with
preexisting conditions. They are now free from that kind of
discrimination. That is so important.
We talked a lot today about the Constitution. Well, prior to the
Constitution we had the Declaration of Independence, and the
Declaration of Independence starts off, ``We hold these truths to be
self-evident, that all men are created equal.'' It probably should have
added ``women'' at that point, but back then it was ``all men are
created equal.''
That is carried forward in the 14th Amendment to the Constitution,
and I have prepared a chart of this, of the language, which says no
State shall deny to any person within its jurisdiction the equal
protection of the laws.
People with prior illnesses, with physical conditions, have been
discriminated against because of those conditions and illnesses. That
is wrong, it is immoral, and in my opinion it is unconstitutional.
In my district, I was standing at a gas station. A guy comes up to me
and he says, You all have to pass that legislation. My daughter has
Crohn's disease. I am in a roofing company. I want to start my own
roofing company, but because she has this disease, I have to stay here.
Otherwise, she will be uninsurable because of her prior condition, and
I am stuck in that job.
Well, this bill, the heart of this bill is to give freedom from that
kind of discrimination against her prior illness, freedom to that
roofer so he can go start his business. That is at the heart of the
American way.
In my own situation, I have a daughter with epilepsy. She didn't ask
to have epilepsy; that is just part of her makeup. But because of the
epilepsy, she is uninsurable, unless she is part of some big group
policy.
So in the Affordable Health Care Act, we have done away with that
kind of discrimination. We have freed people from that kind of
discrimination. The Republican majority, ideologically, radically
driven, wants to take that freedom away, and I will fight that today,
tomorrow, and next week.
With that, I yield back to my friend from Vermont.
Mr. WELCH. I welcome the gentlelady from Maryland, Congresswoman
Edwards.
Ms. EDWARDS. I thank the gentleman. I am so pleased to be here again.
I have been here in the House on this floor for the last hour and a
half because I feel passionately, as we all do, about health care.
There is not one among us, either personally, as the gentleman from
Colorado has expressed, or one of our constituents, who doesn't have a
health care story to share.
So I thought that I would actually share with you a story today, Mr.
Speaker, from a constituent of mine who lives in the Fourth
Congressional District in Maryland. She writes to me that her daughter
graduated from college in 2008 and lost coverage under my--this is from
her--my health insurance.
She got a job in August 2008 that provided her with health insurance
coverage. When she lost that job in June 2009, as millions of Americans
have lost their jobs, she was eligible for COBRA, the continuation of
her health care. Mr. Speaker, she writes that the COBRA subsidy made it
possible for her to continue with that insurance. But then when that
subsidy ended in September of 2010, they had to make a family decision,
she says, to continue to pay for her COBRA coverage until the end of
2010 when it expired. It was an affordability question.
She continues on: We knew she would become eligible for my insurance
at the start of the plan year in January 2011.
And why is that? Because under the Affordable Care Act, she would be
able to cover her daughter for her health insurance and would no longer
have to COBRA that care.
She continues on: The unsubsidized COBRA premium was over $400 a
month, actually closer to $500 a month, and it is going to cost me only
$60 to $70 to add my daughter, now 24, to my employer plan. And some of
her doctors who were not in the network under her COBRA plan are in
network for my plan, meaning we will not have to pay for their full
cost of out-of-pocket costs.
Vicki--I won't say her last name--says to me: I am in the sandwich
generation and help with the care of my stepmother who lives in
Florida. She falls into the part D prescription doughnut hole every
year, so now on January 1 her costs will be reduced because of the
health reform legislation as well.
Mr. Speaker, what I am saying to you and what we say to the American
people today is that this isn't about numbers and statistics; it is
about real people like Vicki and her daughter and her stepmother that
she cares for. It is about real people who, in their lives, work every
single day or are trying to find work and they don't have health care
coverage.
We cannot repeal the Affordable Care Act, because that would be like
throwing ice water on the American people.
With that, I yield back.
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{time} 1810
Mr. WELCH. I want to talk about this question of will promises made
be promises kept. It was the recurring question that was asked by our
colleagues on the other side of the aisle when we were in the majority.
Sometimes it may be uncomfortable because it's a legitimate question.
And we have had to be judged according to our deeds and whether they
matched our promises.
But there's this rules process under way on this health care bill.
There are three issues that have come up. Number one, the fiscal issue.
The Congressional Budget Office has said that this legislation will
increase the deficit by $230 billion. And the Congressional Budget
Office is the neutral arbiter. And we either--both sides--go by the CBO
estimates, or we just say we're going to play this game without a
referee and we're going to make up whatever numbers suit our political
agenda. That is absolutely wrong. We cannot afford to add $230 billion
to the deficit. My colleagues on the Republican side agree with us on
the Democratic side that we cannot do that. It's irresponsible to do
it. And this legislation that repeals health care will add $230 billion
to the deficit.
Secondly, there's this question of the open process. As the Member
from Maryland said, if we're going to have an open process, there has
to be an opportunity for you, for the Member of Colorado, for every
Member to offer their amendments, yes-or-no, on whether we can continue
protection to folks whether they have a preexisting condition or not.
Right now, the law is if you have cancer, you can go out and buy
insurance. Right now, the law is if you have a son or daughter getting
out of college or getting out of high school, going into the labor
force, they can stay on your policy. Right now, the law is if you have
a mom or dad who's on Medicare and you're trying to get preventive
care, they can get it for free. Right now, the law is that if you have
diabetes or you have cancer, you have a serious long-term medical
condition, there's no lifetime cap to cover the medical care that you
need.
The repeal legislation would take away from every single American who
now enjoys those insurance protections. It would take it away from them
suddenly, abruptly, and with nothing to replace it. That's not right.
Now, this is real, by the way. Congresswoman Edwards gave a couple of
stories--and we all have them in all of the districts, including those
who are advocating for repeal. I spoke to Donna Watts who's from
Plainfield, Vermont. She works in Burlington, Vermont, with 20 other
employees. Four of those people that she works with, along with her,
now have their children on their health care policies. Her son got out
of high school, got a $10-an-hour job that came without health care, as
most entry-level jobs do.
And the worst happened. He had a car crash: $20,000 in medical bills.
Those are still largely unpaid--and this family takes seriously their
obligation to pay their bills. They didn't have insurance. With the
passage of the legislation last year on health care reform, Donna Watts
was able to put her son, still uninsured, on her insurance. And she is
asking me, Peter, does this really mean if we repeal health care that
my son loses insurance? And the answer is: Yes. That's not right. We do
not need to do this.
And it raises the other question, If this has not got a political
agenda attached to it, we have gone from a campaign to governing. And
the majority did a great job in the campaign and beat us up pretty good
and have the majority now. But with that, of course, comes the
responsibility of governing in a responsible way. If you're acting
responsibly when you see a problem, you fix it. You don't abolish
everything. You don't abolish a banking system in order to correct the
problems in the financial world. You don't abolish all of the good
things in this health care bill to deal with the things that need to be
addressed.
So this is a very, very serious decision that's being made. It's
going to be a template for the future of this 112th Congress. Are we
going to actually deal with fiscal discipline even when that's
inconvenient with our political agenda? The answer to that for the
American people has to be: Yes. Are we going to protect the progress
that we have made that benefits all of our constituents when it comes
to these insurance reforms, and are we going to have an open process in
this body so that those of us who have a different point of view are
going to have an opportunity for an up-or-down vote?
By the way, that's not about giving us the opportunity to present our
amendments. That's about letting our constituents know where we stand.
Because at the end of the day that's the only basis upon which they can
decide whether to send us back here or send us packing.
At this time I would like to recognize the gentleman from North
Carolina, Representative Price.
Mr. PRICE of North Carolina. I thank the gentleman for yielding and
also for engaging in this dialogue with other Members about the
challenge that we're facing to reduce this country's deficit spending
and reduce the accumulating debt and at the same time to make certain
that quality, affordable health care are available to all of our
citizens.
As the gentleman has pointed out very, very ably, those two
challenges are intricately related. In fact, one of the main reasons
for supporting health insurance reform is because we simply must reduce
our deficit spending and must reduce this country's debt. One of the
main contributors to our country's escalating debt is the kind of
increasing of health care costs that we have seen in recent years. It's
one of the greatest threats to families, to businesses, to the overall
economy. Health care has become the fastest growing component of the
Federal budget, as the gentleman well knows. Last year, health care
accounted for 17 percent of GDP. That's more than twice the average of
other developed nations.
Now, the Patient Protection and Affordable Care Act corrects the
failures of the current system without compromising the many strengths
that we know that it has. And so it's very disconcerting here in this
first week of the new Congress to see our Republican colleagues not
only going after the protections in the health care law, but also
almost immediately abandoning their commitment to fiscal discipline.
Now, the figures that I saw this morning show that the Congressional
Budget Office, the nonpartisan arbiter of budgets decisions for this
body, the Congressional Budget Office has said that the repeal of
health insurance reform as proposed by the Republicans would cost the
Federal budget $230 billion over the next 10 years. That's a revised
estimate, I understand--even greater than was earlier thought. That is
an astounding figure.
Our Republican friends have made a big show out of their commitment
to deficit reduction, but they have made an exception. They have
clearly made an exception for the repeal of health insurance reform. So
not only is this bad health care; not only would it, for example, say
to families who only now are being able to insure their children with
preexisting conditions, No, we're going to go back to the old way where
the insurance companies can deny coverage to your children. What about
those families that now are able to include their 24-, 25-year-olds on
their families' policies? No, they're saying go back to the old way
where that wasn't possible. What about our Medicare recipients who
finally are going to get some relief from these uncovered drug
expenses, the so-called doughnut hole? They're saying, Oh, no, you're
going to have to once again pay those full expenses.
So it's certainly bad policy in terms of health care. But then, to
add insult to injury, adding $230 billion to this country's debt burden
over the next 10 years, and to do that without batting an eye, without
any kind of recognition that this has an impact on the budget deficit,
that's just almost unbelievable that the Republicans would be so
audacious as to propose this in the first week of a new Congress.
And then to add another insult to injury, they're violating their
very own pledge of openness in the way this is going to be considered.
I'm sure this gentleman has been watching, as I have, the Rules
Committee all day today. It's astounding. Yesterday, there was this
commitment to open rules, to open debate, to the offering of
amendments. Today, they're saying, We're going to shut it down. It's an
up-
[[Page H100]]
or-down vote. Maybe we'll get around later to some of these other
questions, some of the repair aspect of repeal and repair, but right
now we're just going to repeal it and let the chips fall.
{time} 1820
That is horrible procedure. It's a shutting down of this Congress
before we even start. It's horrible budget policy. It's horrible health
policy. It's a very, very bad way to start this Congress.
I appreciate the gentleman for calling us together tonight to talk
about this, because we need to talk about it. We need to think about
it. We need to fight it in every way we can.
Mr. WELCH. Thank you very much, Mr. Price.
I recognize the gentleman again from Colorado.
Mr. PERLMUTTER. Well, I'd say to my friend from North Carolina that
he was talking about the fact that seniors will see this doughnut hole,
their prescription drug prices go back up, the costs go back up; but
even, I think, more worrisome than that is the fact that, under the
Affordable Care Act, those same seniors receive $250.
In my district in Colorado, the suburbs of Denver, 31,000 seniors
received this past fall $250 in assistance to payments of their
prescription drugs. Even with that, we still save the $230 billion that
you were talking about. Yet, when the Republicans repeal this in kind
of an ``all or nothing'' situation, do those seniors have to pay that
$250 back, each of them? I don't know. I think they ought to be worried
about that, and that's why this is such an extreme measure.
They are taking away freedoms that belong to the people, that belong
to Americans. They are doing it in a radical and ideological way. When
they said during the campaign, you know, Let's put people back to work,
and let's not spend too much money, they're spending more. They're
taking away freedoms, and I am concerned that those seniors are going
to have to pay that $250 back, per senior. The seniors should be
concerned as well.
This is a radical act, Mr. Speaker and Mr. Price. We have got to
fight it. I hate fighting these battles right out of the box, but if
they're going to take these kinds of radical positions, we have no
choice.
With that, I would yield to my friend from Oregon (Mr. Blumenauer).
Mr. BLUMENAUER. Thank you. I appreciate the gentleman's courtesy for
permitting me to speak just as I appreciate my colleagues coming to the
floor to spotlight something that each and every American needs to be
deeply concerned about.
I listened, for example, for the last 4 years, as a member of the
Budget Committee, to my dear friend and colleague Mr. Ryan talk about
the skyrocketing problem of escalating entitlement under Medicare.
Absolutely right. There are 79 million of the geezer baby boomers like
me who are going to start collecting Medicare--10,000 a day starting
this week and continuing for 19 years--and because of the development
of more improvements in health care, not only are there more of us, but
we are going to want more complex and expensive care.
My Republican friends were talking about an entitlement crisis. The
irony was--and we all heard it on the campaign trail--they talked about
slashing Medicare, which they want to repeal starting next week. A
great deal of irony. As the independent scorekeeper--the Congressional
Budget Office--has pointed out and as you have repeated on the House
floor, the legislation will, in fact, save several hundred billion
dollars. More important than that, it puts in place reforms that will
further reduce entitlement spending.
I know my good friend from Vermont is well familiar with the
Dartmouth Atlas in dealing with health care disparities around the
country. I come from a part of the country where one of the problems we
have is that Medicare needs to be reformed, which is what we started in
this legislation. They're relatively modest steps, but they're going to
save a couple hundred billion dollars. We need to do more. Rather than
repealing these reforms, like stopping unnecessary hospital re-
admissions--just that item costs over $12 billion a year--these reforms
could enable us to bend the cost curve. If everybody practiced medicine
the way it's practiced in metropolitan Portland, Oregon, which is half
the price of McAllen, Texas, or Miami, Florida, there wouldn't be an
entitlement crisis for decades to come.
I appreciate my colleagues focusing on the hypocrisy and on the
recklessness of trying to repeal health care reform that makes a
difference for 32 million uninsured Americans and that provides more
benefit for the seniors with their prescription drugs. Most important
and under-appreciated is that it would reform Medicare so that, instead
of driving us off a cliff over the next 20 years, it would, in fact,
help us change how medicine is practiced to provide incentives for
value, medical value, rather than just volume.
Mr. WELCH. Thank you, the gentleman from Oregon.
Mr. Speaker, may I inquire as to how much time I have?
The SPEAKER pro tempore. The gentleman has 3 minutes remaining.
Mr. WELCH. All right. Let me just ask the gentleman from North
Carolina, Would you like to make any closing remarks and then yield to
the gentleman from Colorado?
Mr. PRICE of North Carolina. I thank the gentleman.
I would like to just underscore what our colleague from Oregon has
just said.
There is so much concern, obviously--and for good reason--about the
future of Medicare. The most conservative estimate I have seen is that
health care reform extends the fiscal solvency of Medicare by 8 years,
and some estimates are much more than that. So to simply throw that
overboard as well as to talk about this doughnut hole--these thousands
of dollars that senior citizens are paying full freight on for
medicines they simply must have--and this gap in coverage is
ridiculous, and we are finally fixing it. What insurance policy do any
of us know about that would have that kind of gap in coverage?
As the gentleman from Colorado said, $250 payments this year. I mean,
I guess this raises the question as to whether even that might be taken
back; but in future years, we are going to close that doughnut hole,
and we are going to extend the solvency of Medicare. Anybody concerned
about the health care for this country's senior citizens simply has to
be very, very alarmed about what is going on in this House right now.
Mr. WELCH. Thank you, the gentleman from North Carolina.
I yield for the final word from the gentleman from Colorado.
Mr. PERLMUTTER. Sure. I appreciate my friends.
You know, instead of amending or repairing, as Mr. Price from North
Carolina described it, they want to repeal, just take it away.
Well, they're taking away freedoms. They're taking away the freedom
from discrimination for prior illnesses, like my daughter with
epilepsy, like the daughter who had Crohn's disease, or the friend at
the gas station. It's taking away the freedom from cancellation because
you get sick, you know, and lose your insurance. You know, it's taking
away the freedom to move jobs so you're not stuck in a job, so you can
move jobs and not fear losing your insurance. I mean, they're taking
away a lot--and maybe this $250 that went to the seniors. It is a
radical move to take these freedoms away, and I hope they think twice
and don't vote to repeal.
With that, I would yield back to my friend from Vermont for his final
remarks.
Mr. WELCH. Well, I thank my colleagues for being here.
The bottom line is, anytime we pass a major piece of legislation, we
should have the humility to acknowledge it can be improved--and we all
do. We can make it better. We can make it stronger. But this totally
destroys things that we have been fighting for decades to achieve on
behalf of the American people: help for seniors with their prescription
drugs, extending the financial viability of Medicare, changing and
encouraging a new way of delivering health care services, moving away
from fee-for-service, volume-driven to patient-centered, performance-
based care, and then insurance reforms that put the patients in charge,
which acknowledge that we are all in it together. This takes away the
absolute unilateral power of for-profit insurance companies to decide
whether your daughter or mine has health care.
[[Page H101]]
Thank you, Mr. Speaker. I appreciate your consideration.
____________________